Nursing Home Vulnerabilities amid COVID-19 Pandemic: A Study of Midwestern States

Background: The COVID-19 pandemic disproportionately affected the older adult population, especially those in nursing homes (NHs). However, there is also evidence that some NHs fared better than others. Objectives: This study examines a set of nursing home related factors to understand whether these factors are associated with the number of COVID-19 cases. Design: We combined three datasets from the Centers for Medicare & Medicaid Services (CMS) – the Star Rating Dataset, the Provider Information Dataset, and the COVID-19 Nursing Home Dataset. Setting and Participants: 4390 NHs that responded to the CMS survey. Methods: Data used is from the period of Jan 1–Dec 27, 2020 for all 12 Midwestern states. The measures used were self-reported information on ratings, staff shortages, PPE shortage, number of beds, Registered Nurse (RN), Licensed Practical Nurses (LPN), Certified Nursing Assistants (CNA) hours per resident, star rating and ownership. Results: Of the 4390 NHs in 12 Midwestern states, high performing NHs were less likely to have more than 30 COVID-19 cases versus low-performing facilities for two of the CMS domains (health inspections, 520 NHs [27.6%] vs 1363 NHs [72.4%]; and staffing 773 NHs [41.1%] vs 1110 NHs [58.9%]). There was also a statistically significant association COVID-19 cases and star rating, NH ownership, NH size, RN, LPN, and CNA staffing in NHs (all p ≤ 0.01). NH ownership status persisted as a predictor of COVID 19 cases when controlled for NH size. Conclusions: Our study highlights two interesting findings. A) a statistically significant association between NH ownership structure and COVID-19 cases among residents - for-profit NHs had higher number of COVID-19 cases B) a statistically significant negative association between RN and CNA staffing and COVID-19 cases (i.e., more staffing hours of RNs and CNA correlated with a smaller number of COVID-19 cases) and a statistically significant positive association between LPN staffing and COVID-19 cases. We discuss ensuing policy implications for NHs.

Download Full-text

Board Characteristics and Firm Performance: Indian Textiles Sector Panorama

Management and Labour Studies ◽

10.1177/0258042x211026148 ◽

2021 ◽

pp. 0258042X2110261

Author(s):

Mukesh Nepal ◽

Rajat Deb

Keyword(s):

Firm Performance ◽

Positive Association ◽

Policy Implications ◽

Board Independence ◽

Board Size ◽

Significant Positive Association ◽

Jel Codes ◽

Financial Measures ◽

Panel Data Regression ◽

Data Regression

The study has attempted to examine whether the board size and board independence have any impact on the financial performances of the Indian textile firms. Accessing the data of the 40 sample firms representing the top 100 BSE-listed textile firms during the timeline 2015–2019 and applying the panel data regression model, it has assessed the impacts. Accounting- and market-based financial measures have been proxied, and a significant positive association between the board size and firm performance has been established. Interestingly, a significant inverse relationship between the board independence and financial performance has also been indicated. It has concurred policy implications as the inclusion of more number of board members would likely to increase the firm performance. Moreover, for improving the sound decision-making, firms may chalk out a policy with capping on the engagement of independent directors in other firms. It has acknowledged a few limitations and has sketched a roadmap for posterior studies as well. JEL Codes: G28, G30, M40

Download Full-text

Association of Dietary and Lifestyle Inflammation Score With Metabolic Syndrome in a Sample of Iranian Adults

Frontiers in Nutrition ◽

10.3389/fnut.2021.735174 ◽

2021 ◽

Vol 8 ◽

Author(s):

Fatemeh Dehghani Firouzabadi ◽

Ahmad Jayedi ◽

Elaheh Asgari ◽

Zahra Akbarzadeh ◽

Nasim Janbozorgi ◽

...

Keyword(s):

Metabolic Syndrome ◽

Adult Population ◽

Positive Association ◽

Population Based ◽

Cross Sectional Study ◽

Significant Positive Association ◽

Cross Sectional ◽

General Adult Population ◽

Education Status ◽

Inflammation Score

Objective: We aimed to evaluate the association between the dietary and lifestyle inflammation score (DLIS) and metabolic syndrome (MetS) and its components in a sample of Iranian adults.Design: Population-based cross-sectional study.Setting: General adult population living in Tehran, Iran.Subjects: We included 827 adult men and women with an age range of 18–59 years who were referred to health centers in different districts of Tehran, Iran. Dietary intake was assessed by a semiquantitative food frequency questionnaire with 168 items. The DLIS was calculated based on four components, including dietary inflammation score, physical activity, cigarette smoking, and general obesity. Higher DLIS represents a more proinflammatory diet and lifestyle. The odds ratio (OR) and 95% confidence interval (CI) of the MetS across quartiles of the DLIS was calculated by using logistic regression analysis, controlling for age, sex, energy intake, marital status, education status, and occupation.Results: A total of 827 participants (31% men) were included, with a mean age of 44.7 ± 10.7 years. The prevalence of the MetS was 30.5%. The DLIS ranged between −2.35 and +3.19 (mean ± SD: 0.54 ± 1.09). There was a significant positive association between the DLIS and odds of MetS (OR fourthvs.thefirstquartile: 1.57, 95% CI: 1.01–2.45) in the fully adjusted model.Conclusion: Our results showed a significant positive association between the DLIS and odds of MetS. The results of the present crosssectional study suggested that having a more proinflammatory lifestyle can be associated with MetS. More prospective studies are needed to confirm the findings.

Download Full-text

Disparities in Risks of Malaria Associated with Climatic Variability among Women, Children and Elderly in the Chittagong Hill Tracts of Bangladesh

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249469 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9469

Author(s):

Theophilus I. Emeto ◽

Oyelola A. Adegboye ◽

Reza A. Rumi ◽

Mahboob-Ul I. Khan ◽

Majeed Adegboye ◽

...

Keyword(s):

Climatic Variability ◽

Group Analysis ◽

Positive Association ◽

Malaria Prevention ◽

Policy Implications ◽

Weather Data ◽

Chittagong Hill Tracts ◽

District Health ◽

Significant Positive Association ◽

Delayed Effects

Malaria occurrence in the Chittagong Hill Tracts in Bangladesh varies by season and year, but this pattern is not well characterized. The role of environmental conditions on the occurrence of this vector-borne parasitic disease in the region is not fully understood. We extracted information on malaria patients recorded in the Upazila (sub-district) Health Complex patient registers of Rajasthali in Rangamati district of Bangladesh from February 2000 to November 2009. Weather data for the study area and period were obtained from the Bangladesh Meteorological Department. Non-linear and delayed effects of meteorological drivers, including temperature, relative humidity, and rainfall on the incidence of malaria, were investigated. We observed significant positive association between temperature and rainfall and malaria occurrence, revealing two peaks at 19 °C (logarithms of relative risks (logRR) = 4.3, 95% CI: 1.1–7.5) and 24.5 °C (logRR = 4.7, 95% CI: 1.8–7.6) for temperature and at 86 mm (logRR = 19.5, 95% CI: 11.7–27.3) and 284 mm (logRR = 17.6, 95% CI: 9.9–25.2) for rainfall. In sub-group analysis, women were at a much higher risk of developing malaria at increased temperatures. People over 50 years and children under 15 years were more susceptible to malaria at increased rainfall. The observed associations have policy implications. Further research is needed to expand these findings and direct resources to the vulnerable populations for malaria prevention and control in the Chittagong Hill Tracts of Bangladesh and the region with similar settings.

Download Full-text

Association of coffee and caffeine intake with irritable bowel syndrome in adults

10.21203/rs.3.rs-35477/v1 ◽

2020 ◽

Author(s):

Glareh Koochakpoor ◽

Asma Salari-Moghaddam ◽

Ammar Hassanzadeh Keshteli ◽

Ahmad Esmaillzadeh ◽

Peyman Adibi

Keyword(s):

Logistic Regression ◽

Adult Population ◽

Binary Logistic Regression ◽

Positive Association ◽

Cross Sectional Study ◽

Caffeine Intake ◽

Dietary Intakes ◽

Caffeine Consumption ◽

Significant Positive Association ◽

Cross Sectional

Abstract Background: The aim of this study was to investigate the association between coffee and caffeine intake and odds of IBS and its severity in adult population. Methods: In this cross-sectional study, dietary intakes of 3363 Iranian adults were examined using a validated dish-based 106-item Semi-quantitative Food Frequency Questionnaire (DS-FFQ). Coffee and caffeine intake was assessed using the DS-FFQ. IBS was assessed using a modified Persian version of Rome III questionnaire. Binary logistic regression, in which the effect of several potential confounders were controlled for, was used to examine the association between coffee and caffeine intake and prevalence of IBS and its subtypes. To identify the association with severity of IBS symptoms, we applied ordinal logistic regression. Results: After adjustment for potential confounders, we found that individuals who were taking coffee weekly or more had greater odds of IBS (OR:1.50; 95% CI: 1.07-2.11) than those who never drinking coffee. In addition, participants in the top tertile of caffeine intake had 49% greater odds of IBS compared to those in the bottom tertile (OR: 1.49; 95% CI: 1.16-1.90). By gender, this association was observed among women, but not in men (for coffee: OR: 1.50; 95% CI: 1.00-2.57 and for caffeine: OR: 1.50; 95% CI: 1.12-2.02). In addition, a significant positive association was seen between caffeine intake and odds of IBS among subjects with BMI≥25 kg/m2 (OR: 1.76; 95% CI: 1.22-2.53). There was no significant association between coffee and caffeine intake and IBS severity.Conclusion: Coffee and caffeine consumption was associated with increased odds of IBS, in particular among women and those with BMI ≥ 25 kg/m2.

Download Full-text

Risk Governance and Bank Performance

10.4018/978-1-7998-8609-9.ch006 ◽

2022 ◽

pp. 99-115

Author(s):

John Agyekum Addae ◽

Emmanuel Numapau Gyamfi

Keyword(s):

Positive Association ◽

Policy Implications ◽

Risk Governance ◽

Regulatory Oversight ◽

Significant Positive Association ◽

Bank Profitability ◽

Global Discourse ◽

Risk Committee ◽

The Relationship ◽

Global Banks

Global discourse is geared towards greater accountability and regulatory oversight of banks to promote sound financial systems and charter value. The authors applied dynamic pool panel analysis to investigate the relationship between risk governance and financial performance among African global banks spanning the years 2015 to 2020. They find significant positive association between financial experts on risk committee and bank profitability. The results further reveal that risk committee activism as a proxy for risk committee effectiveness significantly increase bank profitability. Therefore, stakeholders must prioritize regular risk committee meetings and attach importance to risk committee compositions with finance experts on the majority. Additionally, this study offers policy implications for regulators and bank mangers to clearly define risk committee financial experts and minimum financial experts required to serve on the risk committee.

Download Full-text

Association of Coffee and Caffeine Intake With Irritable Bowel Syndrome in Adults

Frontiers in Nutrition ◽

10.3389/fnut.2021.632469 ◽

2021 ◽

Vol 8 ◽

Author(s):

Glareh Koochakpoor ◽

Asma Salari-Moghaddam ◽

Ammar Hassanzadeh Keshteli ◽

Ahmad Esmaillzadeh ◽

Peyman Adibi

Keyword(s):

Adult Population ◽

Positive Association ◽

Cross Sectional Study ◽

Caffeine Intake ◽

Dietary Intakes ◽

Caffeine Consumption ◽

Significant Positive Association ◽

Cross Sectional ◽

Rome Iii ◽

Obese Subjects

The aim of this study was to investigate the association between coffee and caffeine intake and odds of IBS and its severity in adult population. In this cross-sectional study, dietary intakes of 3,362 Iranian adults were examined using a validated dish-based 106-item Semi-quantitative Food Frequency Questionnaire (DS-FFQ). Coffee and caffeine intake was assessed using the DS-FFQ. IBS was assessed using a modified Persian version of Rome III questionnaire. After adjustment for potential confounders, we found that individuals who were taking coffee weekly or more had greater odds of IBS (OR:1.44; 95% CI: 1.02-2.04) than those who never drinking coffee. In addition, participants in the top tertile of caffeine intake (≥106.5 mg/d) had 47% greater odds of IBS compared to those in the bottom tertile (<69.4 mg/d) (OR: 1.47; 95% CI: 1.14-1.87). By gender, a significant association was observed between caffeine intake and odds of IBS among women (OR for those in the highest tertile vs. lowest tertile: 1.48; 95% CI: 1.10-2.00), but not in men (OR: 1.47; 95% CI: 0.94-2.30). In addition, a significant positive association was seen between caffeine intake and odds of IBS among subjects with BMI ≥ 25 kg/m2 (OR for those in the highest tertile vs. lowest tertile: 1.72; 95% CI: 1.20-2.48). There was a significant association between caffeine intake and IBS severity among subjects with BMI ≥ 25 kg/m2 (OR: 1.04; 95% CI: 1.01-2.62). In conclusion, coffee and caffeine consumption was associated with increased odds of IBS in the whole study population. The association between caffeine and odds of IBS was also significantly positive among women and overweight or obese subjects (BMI ≥ 25 kg/m2). In addition, we found a significant relationship between caffeine intake and severity of IBS symptoms among overweight or obese subjects (BMI ≥ 25 kg/m2).

Download Full-text

Role of Knowledge, Sociodemographic, and Behavioral Factors on Lifetime HIV Testing among Adult Population in Nepal: Evidence from a Cross-Sectional National Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183311 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3311

Author(s):

Bimala Sharma ◽

Eun Woo Nam

Keyword(s):

Hiv Testing ◽

Adult Population ◽

Multivariate Logistic Regression Analysis ◽

Secondary Data ◽

Positive Association ◽

Behavioral Factors ◽

Hiv Knowledge ◽

Significant Positive Association ◽

Cross Sectional

Human immunodeficiency virus (HIV) testing is important to HIV prevention, treatment, and care. We aimed to assess the role of sociodemographic, behavioral factors and HIV knowledge on HIV testing among people aged 15–49 years in Nepal. The 2011 Nepal Demographic and Health Survey data was used for secondary data analysis. Herein, 9843 women and 3017 men who had experienced coitus were included. The respondents were asked if they underwent HIV testing and received the test results in their lifetime. Chi-square test and multivariate logistic regression analysis were applied at 5% level of significance. Adjusted odds ratios and 95% confidence intervals were computed separately for women and men. Of the total, 18.0% of men and 7.4% of women had been tested for HIV in their lifetime. As compared to the age of 15 to 24 years, males aged 25 to 29 years were more likely to report, whereas females aged 35 to 49 years were less likely to report HIV testing. Lower caste groups had more likelihood of reporting HIV testing than the other caste in both sexes. The odds of being tested for HIV were significantly higher among those who had higher education in both sexes. There was significant positive association between HIV testing and economic status in males whereas this association was reverse among females. The male respondents who spent more than one month away from home in the last 12 months were 1.68 times more likely to have been tested for HIV in their lifetime. Having multiple sexual partners was associated with higher odds of testing for HIV in both sexes. Having comprehensive HIV knowledge was independently associated with the reporting of higher odds of HIV testing in females. Promotion of HIV testing should consider sociodemographic factors, sexual behavior, and imparting comprehensive HIV knowledge.

Download Full-text

Understanding the association between spirituality and mental health outcomes in adolescents in two non-Western countries: Exploring self-control as a potential mediator

Development and Psychopathology ◽

10.1017/s0954579421001334 ◽

2021 ◽

pp. 1-10

Author(s):

Delshad M. Shroff ◽

Rosanna Breaux ◽

Antje von Suchodoletz

Keyword(s):

Mental Health ◽

Life Satisfaction ◽

Health Outcomes ◽

United Arab Emirates ◽

Positive Association ◽

Self Control ◽

Policy Implications ◽

Mental Health Outcomes ◽

Significant Positive Association ◽

Western Countries

Abstract Empirical knowledge on what specific aspects of mental health are associated with spirituality is limited, and explanations for the mechanisms underlying this association is scarce. Furthermore, there is limited research on this association among individuals from non-Christian religious backgrounds and non-Western countries. The current study examined relations between spirituality and aspects of mental health in 1,544 adolescents from diverse religious backgrounds in two Eastern countries, India and the United Arab Emirates (UAE). Additionally, we examined mediating and moderating factors. Adolescents (58% female) ages 11–15 years completed a questionnaire on aspects of their mental health, spirituality, and self-control abilities. Results showed that spirituality had a significant positive association with life satisfaction and a significant negative association with internalizing problems, but a non-significant relation with externalizing problems, controlling for age, gender, and socioeconomic status. Self-control completely mediated the association between spirituality and life satisfaction, and this mediational relation was only present for adolescents from the UAE. Results support prior research suggesting positive associations between spirituality and adaptive mental health outcomes and extend these findings to adolescents from diverse religious backgrounds in non-Western countries. These findings have important clinical and policy implications for supporting the role of spirituality in an adolescent’s life.

Download Full-text

COVID-19 and income inequality in OECD countries

The European Journal of Health Economics ◽

10.1007/s10198-021-01266-4 ◽

2021 ◽

Vol 22 (3) ◽

pp. 455-462 ◽

Cited By ~ 1

Author(s):

John Wildman

Keyword(s):

Income Inequality ◽

Gini Coefficient ◽

Positive Association ◽

Oecd Countries ◽

Policy Implications ◽

Vulnerable Groups ◽

Significant Positive Association ◽

Cross Sectional ◽

Regression Methods ◽

The Gini Coefficient

Abstract Objective To determine the association between income inequality and COVID-19 cases and deaths per million in OECD countries. Methods Cross-sectional regression methods are used to model the relationship between income inequality, as measured by the Gini coefficient, and COVID-19 reported cases and deaths per-million. Results The results demonstrate a significant positive association between income inequality and COVID-19 cases and death per million in all estimated models. A 1% increase in the Gini coefficient is associated with an approximately 4% increase in cases per-million and an approximately 5% increase in deaths per-million. Conclusions The results demonstrate that countries with high levels of income inequality have performed significantly worse when dealing with the COVID-19 outbreak in terms cases and deaths. Income inequality is a proxy for many elements of socioeconomic disadvantage that may contribute to the spread of, and deaths from, COVID-19. These include poor housing, smoking, obesity and pollution. Policy Implications The findings suggest the importance of closing the gap in income inequality and improving the health and incomes of the poorest and most vulnerable groups.

Download Full-text

COVID-19 Nursing Home Deaths in Cook County: Predictors and Modifiable Risks

Innovation in Aging ◽

10.1093/geroni/igab046.2006 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 523-523

Author(s):

Andrew DeMott ◽

Susan Hughes ◽

Michael Gelder ◽

Sage Kim

Keyword(s):

Older Adults ◽

Nursing Home ◽

Nursing Homes ◽

Policy Research ◽

Cook County ◽

Policy Implications ◽

Nursing Facilities ◽

Skilled Nursing ◽

For Profit ◽

Quality Ratings

Abstract Investigators at the University of Illinois Chicago, the Illinois Department on Aging (IDOA), the Illinois Department of Public Health, and the Health and Medicine Policy Research Group are collaborating to examine comparative rates of Covid-19-related deaths among older adults who reside in nursing homes vs. the community in Illinois. As a first step, we have examined data from the Cook County Medical Examiner’s office to compare nursing home resident fatalities to those who died in the community. Deaths with Covid-19 listed as primary or secondary cause of death that occurred between January 1, 2020 to September 30, 2020 among older adults ages 60 and over were identified from the Cook County Medical Examiner’s Office case archive file. Location at death and race/ethnicity were obtained from the same source. Location at death was matched with data in the Center for Medicare and Medicaid Services (CMS) Covid-19 Nursing Home Data to identify persons who died in skilled nursing facilities (SNFs) as well as facility and staff characteristics. We found that the 3,937 deaths among persons over the age of 60 comprised 75% of total deaths in Cook County. Of the total older adult deaths, 2,090 (53%) died in the community and 1,837 (47%) died in SNFs. Regression analyses that controlled for CMS quality ratings found that larger, for-profit nursing homes, with high levels of staff infected with Covid-19 were associated with higher mortality. The policy implications of these findings will be discussed.

Download Full-text